scholarly journals Management of Chronic Noninfectious Uveitis with Low-Dose Methotrexate

2021 ◽  
Author(s):  
Yong-Hui Kim ◽  
Mi-Ryong Ko ◽  
Kang-Chol Ryu ◽  
Il-Hyok Kang
Keyword(s):  
Visual Acuity ◽  
Adverse Reactions ◽  
Low Dose ◽  
Medical Science ◽  
Oral Methotrexate ◽  
Dose Methotrexate ◽  
Dose Oral ◽  
The Mean ◽  
Sparing Effect ◽  
Steroid Sparing

Abstract Purpose To evaluate the effectiveness of low-dose oral methotrexate(5mg/week) among chronic noninfectious uveitis patients who were unresponsive to conventional steroids therapy. Methods 27 patients with chronic noninfectious uveitis who were treated with low-dose methotrexate (MTX) at ophthalmology department of Pyongyang University of Medical Science Hospital from 2017 to 2020 were participated in this study.Each patient received oral MTX at dose of 5mg/week except that 2 patients were given 7.5mg/week MTX for the first 4 weeks. The treatment effects were evaluated based on ratio of inflammation control, Log MAR visual acuity, mean number of relapses and steroid-sparing effect. Every adverse effect associated with drug use was recorded. Results Control of inflammation was achieved in 92.6% of patients. Visual acuity was improved in 82.9% (29 eyes among 35 eyes) and maintained in 5.7% (2 eyes). The mean number of relapses was decreased from 4.2 (before therapy) to 1.9 (after therapy). Steroid-sparing effect was achieved in 85.2% patients. There was no serious side effect requiring discontinuation of therapy but some adverse reactions were recorded in 22.2% of patients. Conclusions Low-dose methotrexate(5mg/week) is supposed to be able to successfully control chronic noninfectious uveitis and has a steroid-sparing effect. It is also safer because it shows less adverse effects.

Low-dose oral methotrexate for the management of childhood Cogan’s syndrome: a case report

2007 ◽  
Vol 26 (12) ◽  
pp. 2201-2203 ◽  
Author(s):  
Yuzaburo Inoue ◽  
Takuya Tomemori ◽  
Shuichi Suzuki ◽  
Takayasu Arima ◽  
Minako Tomiita ◽  
...  
Keyword(s):  
Case Report ◽  
Low Dose ◽  
Cogan’S Syndrome ◽  
Oral Methotrexate ◽  
Cogan's Syndrome ◽  
Dose Oral

Low-dose oral methotrexate in chronic progressive multiple sclerosis: Analyses of serial MRIs

Neurology ◽  
1996 ◽  
Vol 47 (5) ◽  
pp. 1153-1157 ◽  
Author(s):  
D.E. Goodkin ◽  
R.A. Rudick ◽  
S. V. Medendorp ◽  
M.M. Daughtry ◽  
C. Van Dyke
Keyword(s):  
Multiple Sclerosis ◽  
Low Dose ◽  
Progressive Multiple Sclerosis ◽  
Oral Methotrexate ◽  
Chronic Progressive Multiple Sclerosis ◽  
Dose Oral

Low dose oral methotrexate in rheumatoid arthritis: An uncontrolled trial and review of the literature

1983 ◽  
Vol 12 (4) ◽  
pp. 333-347 ◽  
Author(s):  
Gerald D. Groff ◽  
Keith N. Shenberger ◽  
William S. Wilke ◽  
Thomas H. Taylor
Keyword(s):  
Rheumatoid Arthritis ◽  
Low Dose ◽  
Review Of The Literature ◽  
Oral Methotrexate ◽  
Uncontrolled Trial ◽  
Dose Oral

scholarly journals Clinical Characteristics and Efficacy of Adalimumab and Low-Dose Methotrexate Combination Therapy in Patients With Vogt–Koyanagi–Harada Disease

2022 ◽  
Vol 8 ◽  
Author(s):  
Tomona Hiyama ◽  
Yosuke Harada ◽  
Yoshiaki Kiuchi
Keyword(s):  
Side Effects ◽  
Combination Therapy ◽  
Immunosuppressive Therapy ◽  
Median Duration ◽  
Cyclosporine A ◽  
Clinical Characteristics ◽  
Low Dose ◽  
Dose Methotrexate ◽  
Therapy Methotrexate ◽  
Steroid Sparing

This retrospective study investigated the clinical characteristics and efficacy of adalimumab and low-dose methotrexate combination therapy in patients with Vogt–Koyanagi–Harada disease who were treated at Hiroshima University from February 2012 to May 2021. The patients' demographics, clinical features at administration of immunosuppressive therapy, steroid-sparing immunosuppressive therapy, side effects, and relapses were recorded. The efficacies of steroid-sparing immunosuppressive therapy (methotrexate, cyclosporine A, adalimumab, and adalimumab and methotrexate combination therapy) were analyzed. Among 62 patients, the median age at diagnosis was 47 years and the median duration of uveitis was 51 months. Systemic corticosteroid therapy was administered to 93.5% of patients (n = 58). Thirty-four patients (54.8%) were treated with steroid-sparing immunosuppressive therapy. Methotrexate and cyclosporine A were administered to 12 and 22 patients, respectively; relapse occurred in 50.0% and 22.7% of the patients, respectively. Discontinuation of cyclosporine A was required in 63.6% of patients because of side effects. Adalimumab was administered to 14 patients. Recurrence occurred in 11 patients, requiring methotrexate concomitantly. The mean dose of methotrexate at inflammatory quiescence after side effect-related dose decrease was 8.0 mg/week (0.13 mg/kg). The median duration of combination therapy without recurrence was 20 months. There were no serious adverse events during adalimumab therapy. A high relapse rate was observed in patients receiving methotrexate; a high rate of side effects requiring discontinuation was observed in patients receiving Cyclosporine A. Patients with late-stage Vogt–Koyanagi–Harada disease may achieve better control with adalimumab and methotrexate combination therapy.

scholarly journals Low-dose Oral Methotrexate Management of Patients with Bilateral Ménière's Disease

2000 ◽  
Vol 79 (2) ◽  
pp. 82-92 ◽  
Author(s):  
Jefferson K. Kilpatrick ◽  
Aristides Sismanis ◽  
Robert F. Spencer ◽  
Christopher M. Wise
Keyword(s):  
Low Dose ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Oral Methotrexate ◽  
Immune Mediated ◽  
Dose Oral ◽  
Ménière's Disease

In this retrospective clinical trial, we evaluated the effectiveness of low-dose oral methotrexate in the management of bilateral Ménière's disease of immune-mediated origin. At our tertiary-care referral center, we evaluated ten men and eight women who had longstanding bilateral Ménière's disease that had been unresponsive to traditional conservative medical management. Sixteen of these patients had steroid-responsive bilateral Ménière's disease. Two patients had contraindications to steroids, but their clinical and laboratory evaluations were consistent with an immune-mediated process. Patients were treated with 7.5 to 20 mg/week of oral methotrexate. The mean duration of treatment was 16.7 months (range: 8 to 35), with a mean followup of 2 years (range: 9 mo to 5 yr). Changes in clinical symptoms (vertigo, hearing loss, tinnitus, and aural fullness), audiometric changes, and side effects of therapy were evaluated. Vertigo resolved in 14 patients (78%), was substantially alleviated in three patients (17%), and remained unchanged in one patient (6%). Hearing improved in five patients (28%) and stabilized in seven patients (39%). Tinnitus and aural fullness resolved or was relieved in 11 of 17 (65%) and 13 of 14 (93%) patients, respectively. Side effects were minimal and reversible. We conclude that low-dose oral methotrexate is effective and safe for treating bilateral Ménierè's disease of immune-mediated origin. In this study, methotrexate alleviated vertiginous symptoms and improved or stabilized hearing in most patients. Low-dose methotrexate can be considered for patients with immune-mediated bilateral Meniérè's disease when long-term treatment is required or when a steroid or cyclophosphamide is contraindicated.

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